What’s New in Flu Vaccine Information New First-In-Class Pleuromutilin Antibiotic for CAP Abdominal Pain in Patients with IUDs—Watch Out for Ectopic Pregnancy Cancer-Causing Chemical Found in Ranitidine Measles Cases and Outbreaks Cooling Pediatric Burns Occ Med: Severe Silicosis in Stone Fabrication Workers An Update on Vaccine the 2019-2020 Flu Season Key points: The CDC recommends annual influenza vaccination for everyone 6 months of age and older, with any licensed influenza vaccine that is appropriate …
Read MoreUpdated IDSA Guidelines Stress Early, Appropriate Treatment for Community-Acquired Pneumonia + Influenza
Urgent message: Just as what is predicted to be a brutal flu season picks up steam, the Infectious Diseases Society of America has released new guidelines stressing the need for timely, dual treatment in adults with community-acquired pneumonia who also test positive for influenza. Cornelius O’Leary, Jr., MD After more than a decade, the Infectious Diseases Society of American has published new guidelines on community-acquired-pneumonia—noteworthy for both its switch from narratives to a Grading of …
Read MoreFor Auld Lange Syne, Many Great Years
The year was 2006: Saddam Hussein was executed for crimes against humanity. The Wii gaming console debuted. Pluto lost its planetary status. High School Musical and Borat were the talk of the town in entertainment. And JUCM, The Journal of Urgent Care Medicine was born—the first and only peer-reviewed journal in the industry (which it remains to this day). Well, let’s just say that JUCM was the undisputed highlight of 2006! The whole idea for …
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Atypical Chest Pain in a Fibromyalgia Patient Presenting to Urgent Care
Tracey Q. Davidoff, MD, FACP, FCUCM Urgent message: Underlying medical and psychiatric conditions can cloud judgment and lead to cognitive errors, which may result in potentially serious medical errors.1 Case Presentation A 31-year-old woman with a medical history significant for fibromyalgia, migraines, bipolar disorder, and anxiety presents with 2 hours of severe bilateral neck spasms, left shoulder and arm pain, and chest pain which began soon after taking a new prescription for olanzapine. She also …
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Ear Pain Mimics: It’s Not All About Otitis Media
Urgent message: Though ear pain is often due to otitis media or externa, it is important to include other diagnoses, some of which could be life-threatening, “can’t miss” causes. Introduction Patient complaints of ear pain (otalgia) are seen frequently in the urgent care setting. It can be frustrating for patients and providers when a patient’s ear pain has no obvious cause. Differential diagnoses include several primary and secondary causes of otalgia. (See Table 1.) Lab …
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A 65-Year-Old Female with Hip Pain After a Stumble
The Case The patient is a 65-year-old woman who presents with pain in her left hip after stumbling down the last step of her front stoop. Her daughter, who witnessed the incident, reports that her mother did not fall and insists she “didn’t even land that hard” on her left leg. Review the image taken and consider what our diagnosis and next steps would be.
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A 13-Year-Old Boy with Hip and Groin Pain After a Soccer Game
The patient is a 13-year-old boy who complains of pain in his right hip and groin after playing soccer. His mother says she didn’t see what happened, but reports that she looked up from a magazine she was reading to see him limping suddenly. View the image taken and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.
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Pediatric Urgent Care—Specialized Medicine on the Front Lines
David Mathison, MD, MBA Thirty years ago, there was widespread concern that specialty medicine was “a problem.” Consumers were self-selecting specialty (vs primary) care for routine ailments, thus driving up the cost of healthcare. Without restrictions, consumers could choose neurologists for headaches, orthopedists for ankle sprains, and dermatologists for acne—all very appropriate with complexity, but unnecessary and costly for routine problems. Hence came the dawn of managed care armed with gatekeepers, referral requirements, and …
Read MoreAbstracts in Urgent Care-November 2019
An Update on Vaccine the 2019-2020 Flu Season Key points: The CDC recommends annual influenza vaccination for everyone 6 months of age and older, with any licensed influenza vaccine that is appropriate for the recipient’s age and health status (IIV, RIV4, or LAIV4) with no preference expressed for any one vaccine over another. All regular dose vaccines are quadrivalent this year. Fluzone (high-dose trivalent vaccine) may provide more protection to those ages 65 and up, …
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When Pregnant Patients Present to the Urgent Care Center
Urgent message: Care of the pregnant patient in urgent care can be complex, as every test or treatment needs to take into account both the mother and her unborn child. Conditions which would be considered benign and self-limited in healthy patients take on a different level of concern, and must be managed differently, in the pregnant patient. James Hicks, MD INTRODUCTION There appears to be a wide variety of comfort levels within any particular urgent …
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